Accutane permanent cure?

[titi7454]

I used to have very bad acne (not from steroids, just lost to the genetic lottery) Nothing helped removed my acne that the dermatologists suggested. It only calmed it a bit. I had acne on my face, back, chest. Sometimes lower back and my ass. I even had some on my head and it hurt when I was getting a haircut.

This was from 14->20 when I finally started using accutane with a medical prescription. The dermatologist saw me and said I needed to take 40mg per day for 14 months (I was 80kg at that time).

I did bloods before and after and my liver was fine. I didn't experience any side effects while on it apart from dry lips and dry skin on my hands.

2 years later and I couldn't be happier with my decision. I get around 2 pimples a month which are gone in like a day or two. I've heard using lower doses just keeps your skin clean while you are on it, whereas higher ones keep you clean for life. (But I suppose side effects are stronger)

The first two pictures are before accutane and the third picture is after accutane

 

[prher]

what is the ideal starting dose for isotretinoin?

 

[Psy-chonaut]

19g total, what’s your weight?

Back then, somewhere around 90 kg approx ... Dose was a total of 19200mg, around 215 mg pr kg ' ish

 

[imthankful]

Back then, somewhere around 90 kg approx ... Dose was a total of 19200mg, around 215 mg pr kg ' ish

Interesting. I honestly do not know how doing a second course and cumulative dose is supposed to go. Perhaps someone else does?

At any rate you can throw the kitchen sink at it till you do another; clindamyacine, adapalene, BP/Hibiclens etc.

Hoping you have a quick turnaround with it

 

[titi7454]

I've run 19000mg - and apparently it wasn't a cure for me, thinking of taking/starting a 2 course but this time only around 12 -14 grams....

- A bit scared, cuz the first round just k!lled me, in all sorts of ways and aspects...

Do you think it could be because it's not about the total dose but about the duration.

Example: 100mg a day for 40 days vs 40mg a day for 100 days. (I'm just guessing)

 

[AllbrandNew]

what is the ideal starting dose for isotretinoin?

No such thing, read the thread form the beginning and you can get a lot of anecdotal info.

 

[Psy-chonaut]

Do you think it could be because it's not about the total dose but about the duration.

Example: 100mg a day for 40 days vs 40mg a day for 100 days. (I'm just guessing)

Just a hypothesis - but there could definitely be some kind of individual response of duration/mg/pr. kg.

We need Mr. @Ghoul for this question!!

Just 2 ridiculous outliers in my head that I think would be a Waste, and duration would play in both cases:

20 mg pr. Week, reaching 20gram = Way to Long duration..

1gram pr. day ( if you somehow could handle the dose and suffering) for 20 days = to short of a duration


(Have read about people trying to micro-dose down to 10 mg. Pr week -> I am a non believer in this approach.)

 

[2ndchancesNK]

I think if you want clearance of acne it is probably best to just follow the recommended .5-1.0mg/kg guideline for 4-6 months to reach 120-150mg/kg cumulative dosage. It’s almost guaranteed for initial clearance. If you truly want to lessen the likelihood of relapse, reaching that 200-220mg/kg guideline is what you should shoot for, but even then there’s no guarantees that will happen for everyone. I think that’s the nuclear option, but gives the best of both worlds given that you need to be at a high enough dosage for a long time to reach it.

I personally think this drug sucks to be on, so I recommend start low, titrate up and assess tolerance and side effects and try to reach around 1mg/kg a day or more and shoot for 4-6 months. I’m on my 74th day today at 7700mg and I can’t imagine going much further than 5-6 months. Hit it hard and fast, but not too fast if you’re not willing to suffer. As Ghoul mentioned previously, he went up to 180mg/day and found the increased side effects far outweighed having to be on a couple extra weeks. I had the same experience going up that high in dose — helpful for racking up cumulative dosage mgs, but simply not sustainable for me.

 

[Catteni]

About to run a protocol. Lingering flank acne even on just Test E and Bold Cyp that is no cystic. Usual andro site acne but now it hasn't gone away.

 

[oxy123]

Definitely has been permanent for me. Can run anything and not get acne after I did 9 months accutane 20mg EOD. Except methyl-tren. That actually gave me acne, it was the most toxic experience I had ever had. But deca etc, no issues

 

[titi7454]

I think if you want clearance of acne it is probably best to just follow the recommended .5-1.0mg/kg guideline for 4-6 months to reach 120-150mg/kg cumulative dosage. It’s almost guaranteed for initial clearance. If you truly want to lessen the likelihood of relapse, reaching that 200-220mg/kg guideline is what you should shoot for, but even then there’s no guarantees that will happen for everyone. I think that’s the nuclear option, but gives the best of both worlds given that you need to be at a high enough dosage for a long time to reach it.

I personally think this drug sucks to be on, so I recommend start low, titrate up and assess tolerance and side effects and try to reach around 1mg/kg a day or more and shoot for 4-6 months. I’m on my 74th day today at 7700mg and I can’t imagine going much further than 5-6 months. Hit it hard and fast, but not too fast if you’re not willing to suffer. As Ghoul mentioned previously, he went up to 180mg/day and found the increased side effects far outweighed having to be on a couple extra weeks. I had the same experience going up that high in dose — helpful for racking up cumulative dosage mgs, but simply not sustainable for me.

Just wondering what side effects are you talking about? I ran .5mg per kg for 14 months and didn't see anything apart from dry lips/skin on my hands.

 

[2ndchancesNK]

Just wondering what side effects are you talking about? I ran .5mg per kg for 14 months and didn't see anything apart from dry lips/skin on my hands.

The drug itself has highly dose dependent side effects — the higher you go, there’s the likelihood that dryness will increase, and sometimes dramatically. I went up to 1.8mg/kg for a short period of time and the dryness of hands, lips, face, eyes, and inside of the nose was unmanageable. The dryness is basically affecting every inch of your body at that point. I’m now down to right around 1mg/kg and the side effects are more manageable in comparison, and eventually that will go down to around .5mg/kg or 50-60mg and I’m sure it will be even a better experience as I taper off and leave the moderate-high doses in my rear view.

Derms have good reason for usually maxing dose at 1mg/kg. Anything below that seems pretty easy to deal with, whereas once you start climbing past that, they would probably be getting multiple calls a day from patients with 1 million concerns.

Also worth noting, it’s been in the teens with very low humidity here, making it all the more challenging to keep skin moisturized.

Again, you can decide the tradeoffs with self-prescribing. Low-moderate dose it for upwards of a year or cut that time in more than half by weathering the increased intensity of side effects. I chose the latter, but there’s nothing wrong with the former. Both approaches work for sure.

 

[prher]

how long should one spend at a given dose before deciding the sides of the current dose are tolerable and its a good idea to bump it up 10-20mg for faster more pronounced effects?

 

[2ndchancesNK]

how long should one spend at a given dose before deciding the sides of the current dose are tolerable and its a good idea to bump it up 10-20mg for faster more pronounced effects?

Good question. Read through the thread and you will see everyone has different experiences, just like with any drug. I would say upping the dose by 20mg every 5-7 days is a good middle ground between an aggressive and non-aggressive approach. 3 days being aggressive, and 10-14 days being non-aggressive and easing in.

Derms usually do it by the month, but I wonder if that would be different if the drug itself didn’t have such strict prescribing guidelines.

 

[ekim]

Please correct me if I'm wrong (been a while since I read the early posts in this thread), but I thought there was a definite benefit (multiple benefits?) that only high daily dose could provide even if the high cumulative protocol is used. I'm not sure if it was maximal body acne reduction and/or maximal relapse prevention. Something like one or maybe both of those. Is that accurate?